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Spinal Motion Restriction (SMR) means?

Holding head/neck in neutral alignment when possible

Limiting spine movement to prevent worsening injury

Spinal Motion Restriction is about minimizing any movement of the spine in a trauma patient with potential spinal injury to prevent secondary damage to the spinal cord. The focus is on keeping the spine as still as possible during assessment and transport, usually through head and neck stabilization, immobilization, and careful handling during log-rolling or transfers. That makes the description of limiting spine movement to prevent worsening injury the best match, because it directly states the purpose and action of SMR.

In practice, you’d stabilize the head and neck in alignment, apply immobilization devices, and move the patient as a unit to avoid twisting or bending the spine. Holding the head in a neutral position is a part of this approach, but the overall aim is to limit movement of the entire spine to protect against further injury. Statements that focus only on a single technique or on anatomy don’t capture the functional goal of SMR.

Do not reposition head if resistance/pain/neurologic symptoms

Nerve bundle inside vertebral canal

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